CAJ | 학술논문

目的：观察艾普拉唑联合铋剂10 d 标准四联方案及序贯方案治疗H ．pylori 感染慢性胃炎患者的临床疗效。方法经胃镜、快速尿素酶试验确诊的H ．pylori 阳性慢性胃炎初治患者200例，按区组随机化分组法分为标准四联方案组和序贯疗法方案组，每组100例，分别接受艾普拉唑＋枸橼酸铋钾＋阿莫西林克拉维酸钾＋左氧氟沙星的10 d 标准四联方案或艾普拉唑＋阿莫西林克拉维酸钾＋左氧氟沙星＋呋喃唑酮的10 d 序贯疗法方案。疗程结束后4～6周内行14 C尿素呼气试验检测H ．pylori根除情况，并观察临床症状改善及不良反应发生情况。符合正态分布、方差齐性的计量资料比较采用t 检验，无序分类资料比较用卡方检验或 Fisher 确切概率法，有序分类资料比较采用两独立样本比较的秩和检验。结果标准四联方案组和序贯疗法方案组H ．pylori 根除率符合方案数据分析分别为88．54％（85/96）和87．23％（82/94）；意向性分析分别为85．00％（85/100）和82．00％（82/100）。标准四联方案组和序贯疗法方案组对上腹痛、反酸、烧心等临床症状缓解有效率分别达95．83％（92/96）和95．74％（90/94），不良反应发生率分别为6．25％（6/96）和7．44％（7/94），且轻微。两组患者在上述3个方面差异均无统计学意义（P 均＞0．05）。结论艾普拉唑联合铋剂10 d 标准四联方案或10 d 序贯疗法方案治疗H ．pylori阳性慢性胃炎患者均可取得临床症状改善率高、不良反应轻、H ．pylori根除率高的疗效。
목적：관찰애보랍서연합필제10 d 표준사련방안급서관방안치료H ．pylori 감염만성위염환자적림상료효。방법경위경、쾌속뇨소매시험학진적H ．pylori 양성만성위염초치환자200례，안구조수궤화분조법분위표준사련방안조화서관요법방안조，매조100례，분별접수애보랍서＋구연산필갑＋아막서림극랍유산갑＋좌양불사성적10 d 표준사련방안혹애보랍서＋아막서림극랍유산갑＋좌양불사성＋부남서동적10 d 서관요법방안。료정결속후4～6주내행14 C뇨소호기시험검측H ．pylori근제정황，병관찰림상증상개선급불량반응발생정황。부합정태분포、방차제성적계량자료비교채용t 검험，무서분류자료비교용잡방검험혹 Fisher 학절개솔법，유서분류자료비교채용량독립양본비교적질화검험。결과표준사련방안조화서관요법방안조H ．pylori 근제솔부합방안수거분석분별위88．54％（85/96）화87．23％（82/94）；의향성분석분별위85．00％（85/100）화82．00％（82/100）。표준사련방안조화서관요법방안조대상복통、반산、소심등림상증상완해유효솔분별체95．83％（92/96）화95．74％（90/94），불량반응발생솔분별위6．25％（6/96）화7．44％（7/94），차경미。량조환자재상술3개방면차이균무통계학의의（P 균＞0．05）。결론애보랍서연합필제10 d 표준사련방안혹10 d 서관요법방안치료H ．pylori양성만성위염환자균가취득림상증상개선솔고、불량반응경、H ．pylori근제솔고적료효。
Objective To investigate the clinical efficacy of ilaprazole and bismuth combined ten-day standard quadruple therapy and sequential therapy in the treatment of patients with Helicobacter pylori (H .pylori)infected chronic gastritis.Methods A total of 200 patients with H .pylori-positive chronic gastritis diagnosed by gastroendoscopy examination and rapid urease test (RUT)were randomly divided into standard quadruple therapy group and sequential therapy group,100 cases in each group.One group received ilaprazole,bismuth,amoxicillin-clavulanatepotassium and ofloxacin 10-day standard quadruple therapy, and the other group received ilaprazole, amoxicillin-clavulanatepotassium, ofloxacin and furazolidone 10-day sequential therapy.In four to six weeks after the therapy,the condition of H .pylori eradication was detected by a 14 C-urea breath test.The improvement of clinical symptoms and adverse effects were also observed. Normal distributed and variance homogenized measurement data were compared by t test,while unordered categorical data were analyzed by chi-square test and the exact probability method,and categorical data were compared by two independent sample rank sum test.Results The per-protocol analysis values of H .pylori eradication rates of the standard quadruple therapy group and the sequential therapy group were 88.54%(85/96)and 87.23%(82/94),respectively,while the intention-to-treat analysis values were 85 .00%(85/100)and 82.00%(82/100 ),respectively.The effective rates of symptomatic relief of upper abdominal pain,acid regurgitation,heart burning in the standard quadruple therapy group and the sequential therapy group were 95 .83%(92/96)and 95 .74%(90/94),respectively. The incidence of adverse effects which weve very mild was 6.25 % (6/96 ) and 7.44% (7/94 ), respectively.There was no statistically significant difference in the above three factors between the two groups (all P >0.05).Conclusions Ilaprazole and bismuth combined 10-day standard quadruple therapy and sequential therapy in the treatment of patients with H .pylori positive chronic gastritis both achieves high rates of H .pylori eradication and symptom relief with mild adverse effects.